Healthcare Provider Details

I. General information

NPI: 1467802207
Provider Name (Legal Business Name): DAYANNA IGLESIAS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2016
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15393 SW 178TH ST
MIAMI FL
33187-7723
US

IV. Provider business mailing address

15393 SW 178TH ST
MIAMI FL
33187-7723
US

V. Phone/Fax

Practice location:
  • Phone: 786-768-1690
  • Fax:
Mailing address:
  • Phone: 786-768-1690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License NumberBCABA0-20-10768
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: